Basic Information
| Provider Information | |||||||||
| NPI: | 1306180740 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALTSHULER | ||||||||
| FirstName: | INESSA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 383 ELLIOT ST # 100 | ||||||||
| Address2: | |||||||||
| City: | NEWTON UPPER FALLS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024641126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3392259202 | ||||||||
| FaxNumber: | 7814300548 | ||||||||
| Practice Location | |||||||||
| Address1: | 383 ELLIOT ST # 100 | ||||||||
| Address2: | |||||||||
| City: | NEWTON UPPER FALLS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024641126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3392259202 | ||||||||
| FaxNumber: | 7814300548 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2012 | ||||||||
| LastUpdateDate: | 02/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.